Every REAL Chinese medicine practitioner, past and present, should be very good at classics, like Huang di nei jing and SHL JGYL and Wen Bing works. They are the guide lines of TCM philosophy and thinking methods. Many TCM doctors nowadays do not have this philosophical concepts and instead, they use Huanglian, Huang qin, Ban lan gen etc. to treat infectious diseases, use Dan shen, San qi to treat coronary heart disease. This is totally modern medicine perception and should not be used in TCM or they actually do not work very well and people will say that Chinese medicine is not a big deal. Those TCM doctors are not REAL Chinese medicine. Every successful TCM doctor must be saphisticaed in using classical formulas. I’m so excited to find this blog and able to share my points of view here.
Hi Delli,
You made a great point here! I always say to my patients and colleagues that studying herbs by isolating the effective extracts and therapeutic ingredients is not the correct approach. TCM originally uses four Qi, five Wei (flavours) and meridian attribution (Gui Jing) to describe herbs’ function but not the ingredients such as ephedra or ephedine. Moreover, there are interactions between herbs in a formula decotion or other forms, which is exceptionally complicated and researching this by modern scientific ways are impracticable. It is like there is no way to find out what exactly meridians (Jing Luo) are by just “guessing” that they might be the communicative part of nervous system, circulatory system and lymph system. Therefore, it is completely wrong to regulate herbs under modern scientific standard. We should regulate the qualifications of practitioners instead of herbs. There is a Chinese term saying that every herb is more or less toxic (是藥三分毒shi yao san fen du). It’s very important that we should grasp what “toxin” means. First of all, the toxic effect is actually the therapeutic effect! Simply speaking, every herb has its yin or yang deviation, in another word, warm or cold nature, in order to correct the imbalance of yin and yang of the body. Hotter or colder means it is more toxic. Secondly, toxic effect is relative. Different people of different constitutions and syndrome differentiations have different response to the same “toxin”. To a person with yin deficiency and internal heat constitution, a piece of ginger is toxic for him or her. While a person suffering Bi syndrome with cold dampness and qi and blood deficiency, large amount of dried ginger and Fu zi are pleased for him or her. I used 20 grams of Ma huang (I usually use 2 to 4 grams in wind cold external syndromes and asthma) in a formula for a female patient who suffers dermatosclerosis for one year and she felt generally warm and significant released of joint pain and neck stiffness after taking the tea. Lastly, comparing to Chinese herbs, western drugs are more toxic. Ridiculously, people are willing to take them everyday! Nowadays, people don’t know yin and yang, don’t know balance, don’t know the rule of nature, don’t sleep until midnight, drink cold drinks and eat cold fruits everyday, they don’t know how to prevent hypertension, diabetes, high cholesteral and cancer, they are told and actually misled to take miscellaneous drugs AFTER they get those health problems. Aspirin is a drug and toxic. It causes uncontrollable bleeding and actually damages the function of Pi (spleen). Unfortunately, people nowadays are misled to take this “toxin” the rest of their lives because they are convinced that they won’t get cardiovascular diseases. And this is supposed to be legal! More and more cancer patients die of over-treating by chemo drugs. Unfortunately, they are threatened to die in a certain length of time without taking chemotherapy. And this is supposed to be legal! This is completely ridiculous!
Hope to listen to every Si Fu master’s point of view in here! And may all wish everybody have a successful, healthy and prosperous year of Dragon!
Kevin
I was excited to welcome Z’ev Rosenberg onto the podcast recently. Z’ev is a practitioner with over 30 years of experience in practice. He teaches and nurtures the Chinese herbal program at Pacific College of Oriental Medicine in San Diego, as well as working with K’an Herb Company & writing on his own blog. Visit those links to learn more about him. You should do so, because what I’ve said barely scratches the surface of what Z’ev offers the Chinese medicine profession.
In this podcast, we mainly discussed the state & nature of the Chinese medicine profession. Z’ev helps us understand the early history of the profession in the states, how things have changed, what troubling and promising streams he sees coming together now. We cover topics like the community acupuncture model, how we should do integrative medicine, how to study Chinese medicine and more.
Do yourself a favor and listen to this without delay.
Some of the texts that Z’ev mentions (aff link)
- Shang han lun
(Treatise on Cold Damage, Zhang Zhongjing)
- Jin gui yao lue (Pearls from the Golden Cabinet, Zhang Zhongjing)
- Nan jing (Classic of difficulties)
- Huang di nei jing su wen (Yellow Emperor’s simple questions)
- Huang di nei jing ling shu (Yellow Emperor’s divine pivot)
He also references the Pacific Symposium, a West coast conference focused on Chinese medicine that comes up every year in the fall, coming again during the second week of November in 2012.
If you like the Deepest Health podcast, and hope I will do more, would you do me a favor and rate this in the iTunes store? Just click this link, then click on “open this podcast in iTunes) and near the bottom of the page you will see the place to add your rating. Thank you!
Related posts:
[...] walks into a Chinese medicine clinic with the above signs, the text suggests we should give them Guizhi tang, yes? But does the information provided by this line alone help us to prescribe Guizhi tang to [...]
There is no use mentioning what has come before – the Dragon energy that has come my way through the yijing, through conversations, through my own presence as Dragon born, through the energy of this coming year – demands a focus on what is coming up and what is flourishing.
Today starts a practice that I know will bring value to all of us who gather to learn as deeply as possible. It will populate this blog for years to come. But, it starts here, at the birth of the year of the Dragon.
Shanghan lun line 12 – part 1
太陽中風，陽浮而陰弱，陽浮者，熱自發，陰弱者，汗自出，嗇嗇惡寒，淅淅惡風，翕翕發熱，鼻鳴乾嘔者,桂枝湯主之.
Tài yáng zhòng fēng, yáng fú ér yīn ruò, yáng fú zhě, rè zì fā, yīn ruò zhě, hàn zì chū , sè sè wù hán, xī xī wù fēng, xì xì fā rè, bí míng gān ǒu zhě, guì zhī tāng zhǔ zhī .
Mitchell-Ye-Wiseman translation
After this brief statement, the ingredients of the formula and how to make it are listed. Because there are multiple modifications listed, I will save that discussion for another day. It’s worth digging into.
In the common way of my personal study of Chinese herbs and herbal formulas, I have added this line to digital flashcards, my Personal Brain, my private wiki and my Devonthink database. If nothing else, this means that I will always have access to the line and its translation and that I will have written it down many times — a proven memory aid. All of these study/memorization methods will be discussed in upcoming posts, as well as in a resource I am creating to bring all my work in that field together.
Also as part of my study flow, I have found information online that relates to this Shanghan lun line, as well as pulled together my private lineage notes from courses I’ve taken with my teachers that relate to this line. Now it is on me to commit the line to memory and to associate everything that I can with it for future reference. That’s the way this works.
I can’t share all of that with you, but my hope is to take this (and all future lines) – bring together all this information, and say whatever interesting things come forward.
This statement is one of those that is talked about in classical Chinese herb circles quite often. I think it’s about as far as most people make it into studying the Shanghan lun. There are a few symptoms listed here, and they are familiar to most of us.
- The sensation of heat, or “fever” as we commonly call it – later qualified to refer to a rather light fever, nothing too intense
- Sweating, though probably not a ton
- Intense aversion to cold, making the patient cower & huddle away from cold
- Aversion to wind, as though the patient were wet (think of how you feel when wet and waiting for the bus – a common Portland phenomenon)
One problem emerges immediately.
If a patient walks into a Chinese medicine clinic with the above signs, the text suggests we should give them Guizhi tang, yes? But does the information provided by this line alone help us to prescribe Guizhi tang to our patients? No. I should note that the listing of ingredients with modifications based on clinical situations helps us a lot, and will be revisited in blog posts to come.
Looking at a line in isolation is often misleading.
Understanding this line at the deepest level seems to require an understanding of the whole text, but understanding the whole text would seem to require that one comprehends this line. A classic paradox.
However, we have no recourse except to continue – to keep track of results – and to return to the parts once we have some grasp of the whole and vice versa. It’s the flow of information processing that takes us into new territory as well as keeping us grounded. An ability to do that is something all our patients will surely be happy about.
One way to proceed even now, aside from memorizing and researching with this information in mind is to deconstruct the formula discussed in the line and, in so doing, come to understand the line more deeply as well as understanding that part of the text more deeply. As already mentioned, we will turn to this task before long.
Guizhi tang is a particularly interesting formula because of its ubiquity.
It is something everybody has learned about, though many fail to use it. It is featured in many other places in the text, for one thing. In a quick check, I identified nearly two dozen lines with different pathologies where guizhi tang was listed as a possible formula to consider.
It is also the core upon which many other formulas are built.
There are the obvious ones – Guizhi jia gui tang (Guizhi tang with extra Guizhi) and Guizhi jia Longgu Muli tang (Guizhi tang with longgu and muli added) and many other formulas which are basically Guizhi tang with additions or subtractions. But, there are also formulas that seem at first glance to be unrelated to Guizhi tang, yet contain it – the most obvious of which is Xiao jian zhong tang – which is guizhi tang with double Baishao and Yitang added.
This, among other reasons, is why I’m so bewildered when Chinese medicine practitioners dismiss Guizhi tang as a formula for clinical use. It’s possible to build an entire clinical practice on understanding this formula alone, in my opinion. It appears that Zhang Zhongjing agrees.
On the blog, I will explore this line & its implications until I feel done (and until I’ve memorized it) and then we’ll move on to other lines. We’ll do this until we’ve gone through the text, then move on to the Jin gui yao lue. Along the way, as we break down formulas, we’ll make frequent and intense forays into Shennong ben cao jing territory. It will probably take a while, but it will be fun.
I find that working with texts and formulas produces all kinds of interesting insights.
This obviously includes stuff about medicine – formulas, pathology, preparation – but also cultural and language based information, insight into clinical practice, even business! I hope you will enjoy the process, and contribute when you feel called to do so.
Speaking of your contribution…
What is one surprising use you’ve found for Guizhi tang. If you don’t have one, why not just mention something this blog post has taught you?
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The ephedra species you mention doesn’t have the essential alkaloids the ma huang, therefore it is useless as a substitute in clinical practice.
I hope you have been enjoying the changes on the new site. The blog archive is steadily being repopulated. New resources are being created and polished. We’re being active on the major social networks. A couple of secret projects behind the scenes. But, the big news this last six months has been the Shennong Relational Herb Learning course.
My first group of students went through, and had a lot of nice things to say about the course. I list some of those comments on the page where you can learn more about the course and register, if you are interested. I hope you are. Why?
Well, obviously, more students means that I can spend more of my time and energy on Deepest Health. The more this site can support me and my family, the more I am able to devote myself to this site and the independent scholarship that takes it from being an interesting blog to being a real resource.
But, more than that, I just cannot tell you how excited I am to reach out to students all over the globe and create an interactive space where we can come together in our mutual interest in classical Chinese herbalism. More students means more conversations, and also more people to tell me what I can do to make the course better. It’s like having a big family – only the family is all over the planet and always talks about dorky Chinese medicine things. Even better!
Anyway – once the next batch of students is all settled in I’m going to be launching a couple of things here at Deepest Health. One is an herbal monograph series. I’m writing a bunch of short books about individual herbs that will bring together data from the classical texts, more modern sources, botany, phenomenology and my clinical experiences. I’m going to sell them, but will also be sharing lots of the information on the blog for free. I’m also working on finding someone to write about classical acupuncture for the site – if you know anyone, send them my way!
So – check out the page for the newly open Shennong Relational Herb Learning Method – and sign up for the course! You won’t regret it. If you know someone else who might be interested, be sure to send them over as well. I’ve got a couple of great bonuses for a limited time as well as a nice deal for people who want to sign up for Shennong 1 and Shennong 2 concurrently.
One more thing! We’re currently pending approval for NCCAOM PDA (CEU) points, so you can use the courses to fulfill your recertification efforts if you are in a place that uses that kind of thing. Just one more reason to join us. :)
Cara – I’m so glad it was helpful! It’s sort of incredible how important this learning styles stuff is. I think that’s particularly true of a body-based knowledge like medicine. Anyway – thanks for your kind comment and Happy new Year to you as well!
Eric, thanks so much for this post. I too became acquainted with my earning style only at the end of my time at NCNM; this would have benefited me greatly in my younger years. I am a TERRIBLE auditory learner! I used to tape lectures and listen, to no avail. Flashcards, notes, reading and reading…not much help either. It turns out that I am VERY affected by semantics, and am hugely a kinesthetic learner. Hula hooping while reciting the Krebbs Cycle, for example. I learned that I simply cannot study with others who need to be orators of the material, because it throws me way off!
I too will be taking NCCAOM boards this year, and I appreciate the tips you have presented in this posting! More gems are always appreciated.
Thanks for all the work you do promoting and investigating Chinese Medicine, and Happy New Year!
Cara
[...] As I’ve made clear in other posts, I’m a big fan of the concept of learning styles. [...]
[...] of what to attack and how (something I’ll cover at a later date), let’s now assume that we have intervened in some way and had some sort of positive effect on the patient. This is where momentum comes [...]
[...] http://deepesthealth.com/2010/strategy-in-chinese-medicine-timing-and-momentum-pt-3/ [...]
[...] If you missed the first installment, please go read about Phenomenology and Chinese Medicine (Part 1). [...]
[...] on the part of the practitioner in their diagnostic process. Perhaps a poor understanding of the patient’s underlying body constitution is at work, or perhaps it’s just a very complicated [...]
Ephedra viridis grows wild and can be harvested in bulk where I live. I often make a simple tea that has surprisingly wonderful effects for the body and mind.
[...] this, the Six Conformation model used by Zhang Zhongjing (called the Six Channel Model in TCM) is without question the most powerful [...]
[...] http://deepesthealth.com/2010/strategy-in-chinese-medicine-timing-and-momentum-pt-1/ [...]
[...] http://deepesthealth.com/2010/strategy-in-chinese-medicine-timing-and-momentum-pt-2/ [...]
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